Late last month, the Centers for Medicare and Medicaid Services (CMS) declared a public health emergency (PHE) in California due to the unprecedented wildfires. And with that declaration, CMS has taken several actions to help ensure that amidst all the challenge, stress and loss with the wildfires, beneficiaries don’t have to worry about their access health care and any crucial, life-saving services they may need. A few of these actions include: providing a Special Enrollment opportunity and Medicare flexibilities for those who need it; provisions to make sure dialysis care is available; suspension of some requirements to replace needed durable medical equipment (DME) and supplies; provisions for flexibility in accessing covered care in a Medicare Advantage and/or Part D plan.
Below are summaries of each of these actions taken from CMS’ recent press release:
Special Enrollment Opportunities and Medicare Flexibilities: CMS will be providing beneficiaries affected by the California wildfires a Special Enrollment Period (SEP) that gives them an additional opportunity to add, drop or change their Medicare health and prescription drug plan in the event they were eligible for another election period and were unable to make an election because of the wildfires. For more information on special enrollment periods, visit: https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/index.html
Dialysis Care: CMS is helping patients obtain access to critical life-saving services. The Kidney Community Emergency Response (KCER) program has been activated and is working with the End Stage Renal Disease (ESRD) Network 18 (Southern CA) and the Health Services Advisory Group (HSAG) for ESRD Network 17 (Northern CA) to assess the status of dialysis facilities in the potentially impacted areas related to generators, alternate water supplies, education and materials for patients and more. They are also assisting patients who have evacuated ahead of the wildfires to receive dialysis services in the location to which they are evacuating. Patients have been educated to have an emergency supply kit on hand including important personal, medical, and insurance information; contact information for their facility, the ESRD Network hotline number, and contact information of those with whom they may stay or out-of-state contacts in a waterproof bag. They have also been instructed to have supplies on-hand to follow a three-day emergency diet. The ESRD Network 18 hotline is 1-800-637-4767, the HSAG Network 17 hotline is 1-800-232-3773, and the KCER hotline is 1-866-901-3773. Additional information is available on the KCER website www.kcercoalition.com.
Medical equipment and supplies replacements:Under the COVD-19 waivers, CMS suspended certain requirements necessary for Medicare beneficiaries who have lost or realized damage to their durable medical equipment, prosthetics, orthotics and supplies as a result of the PHE. This will help make sure beneficiaries can continue to access the needed medical equipment and supplies they rely on each day. Medicare beneficiaries can contact 1-800-MEDICARE (1-800-633-4227) for assistance.
Ensuring Access to Care in Medicare Advantage and Part D: During a PHE, Medicare Advantage organizations and Part D Plan sponsors must take steps to maintain access to covered benefits for beneficiaries in affected areas. These steps include allowing Part A/B and supplemental Part C plan benefits to be furnished at specified non-contracted facilities and waiving, in full, requirements for gatekeeper referrals where applicable.
See the full press release for all details: CMS Offers Comprehensive Support for CA Due to Wildfires.